Provider First Line Business Practice Location Address:
414 E 12TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALHART
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79022-4402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-683-5414
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2014